As Democrats struggle to take back the heavily Republican-dominated state legislature, reproductive rights and health-care access are sure to play out as central issues for both Republican Gov. Rick Scott and his likely opponent Charlie Crist. (RH Reality Check)

In 2010, Republican Rick Scott won the governor’s seat in Florida after beating his opponent Alex Sink by a narrow margin of 62,000 votes. Since then, Scott and the Sunshine State have made the news for illegal voter purges, the killing of Trayvon Martin under the state’s “stand your ground” law, the refusal to expand Medicaid and implement the Affordable Care Act, several pieces of anti-choice legislation, and moreexecutions than any other first-term governor in Florida’s modern history.

This November, Scott will likely face off against an unlikely candidate: former governor of Florida and Republican-turned-Independent-turned-Democratic contender Charlie Crist. Though the Florida primaries are in August, both sides agree that Nan Rich, a Democratic contender and former state senator, has little chance of beating Crist to the election in November. As Democrats struggle to take back the heavily Republican-dominated legislature, reproductive rights and health-care access are sure to play out as central issues for both candidates.

Reproductive Rights

Since taking office in 2011, a slew of anti-choice legislation has made its way to Scott’s desk. According to Lillian Tamayo, chair of the Florida Planned Parenthood PAC, 30 pieces of anti-choice legislation were introduced during Scott’s first term, four of which the governor signed into law.

In June, Scott, a venture capitalist and former chief executive of the largest private for-profit health-care company in the United States, signed a bill that harshened the state’s existing later abortion ban, prompting some backlash from women within the state’s Republican Party. Along with narrowing the exceptions under which a woman can get an abortion after 24 weeks of pregnancy, the bill, HB 1047, also bans abortion at any point during the pregnancy if a doctor deems the fetus viable.

Pro-choice advocates say that Gov. Scott’s stance on abortion is more conservative than most Republicans’ in the state, and that he’ll pay for his far-right stance in the election. “Gov. Scott is so out of step, even with his own party,” said Tamayo, who pointed to the dissenting positions of state Republicans on several abortion bills Scott has signed into law.

In 2011, the Florida legislature passed a bill mandating that an ultrasound be given to a woman prior to her abortion. Several Republican senators spoke out against the legislation, including Sen. Nancy Detert (R-Venice), who said it insulted her. “I personally resent writing legislation that acts like I’m too stupid to confer with my own doctor on what I should do,” she said in a statement. Scott signed the bill into law, and it became effective in July of that year.

In 2013, Scott signed into law the so-called Infants Born Alive Act, which “provides that an infant born alive during or immediately after an attempted abortion is entitled to the same rights, powers, and privileges as any other child born alive.” As RH Reality Checkhas reported, laws like the one signed by Scott rest on a myth: “[T]here is no evidence of a pattern of infants being ‘born alive’ after an abortion, much less of doctors killing infants in those circumstances.”

Tamayo says that the conservative legislature is out of touch with the views of Floridians, who in 2012 soundly defeated an anti-choice ballot initiative, Amendment 6, which would have prohibited the use of public funds for abortion. According to Tamayo, more Floridians voted against Amendment 6 than voted for president that year, evidence that Scott and the Republican legislature “pretending to be physicians” won’t gain them public support this election.

Crist, who was attorney general at the time of his eventually successful 2006 bid for the governor’s mansion, has a long and fraught history in Florida politics. Having first served in the state senate from 1993 to 1999, Crist lost his seat during the 1998 midterms. After regaining his position in Florida politics as attorney general from 2003 to 2007 and then governor, Crist made a run for U.S. Senate in 2010. After initially coming up short in the polls, Crist ran as an Independent, but eventually lost to young Tea Party Republican Marco Rubio. In December 2012, Crist announced via Twitter that he was joining the Democratic Party.

Crist’s action on abortion while governor was varied, changing, and convoluted. According to PolitiFact, throughout his career in Florida politics, “Crist has been all over the map on abortion.”

While running for governor in 2006 as the Republican candidate, Crist told reporters on the campaign trail that he would sign a ban on abortion except in cases of rape, incest, or medical emergencies. Later that year he clarified, “I’m pro-life. I don’t know how else to say it. I’m pro-life, pro-family, pro-business, pro-Republican.”

Almost ten years later, Crist’s current campaign for governor of the nation’s biggest swing state, this time as a Democrat, sends a different message about a woman’s right to choose. “Charlie believes that government should stay out of personal health decisions between a woman and her doctor,” according to Crist’s campaign website.

Political scientists and policy analysts say that Crist’s changing stance on issues like abortion might hurt him during the election. Sean Foreman, a political science professor at Barry University, told RH Reality Check that “voters are sophisticated enough to know that candidates’ positions evolve, but when you seem to have a full-scale transformation over a short period of time, it will lead some to question Crist’s motives and if he stands for any principles.”

Medicaid and the Affordable Care Act

Florida is one of 24 states that have not expanded Medicaid under the Affordable Care Act, and one of 21 states where lawmakers aren’t planning to anytime soon. According to the White House, nearly 850,000 Floridians will remain uninsured because of the legislature’s failure to expand Medicaid. Families USA, a non-partisan research and advocacy organization, estimates that the number is likely to be even higher, noting that nearly 1.8 million Floridians will remain uninsured without Medicaid expansion.

By and large, poor Americans and people of color are most affected when states like Florida opt out of Medicaid expansion. According to the Kaiser Health Foundation, people of color are more likely to be uninsured than white Americans (the uninsured rate is 27 percent and 15 percent, respectively), with Hispanic Americans representing the most uninsured population in the United States (33 percent). The group estimates, however, that Black Americans will be most affected by lawmakers’ decisions not to expand Medicaid. “Four in ten uninsured Blacks with incomes low enough to quality for the Medicaid expansion fall into the gap, compared to 24 percent of uninsured Hispanics and 29 percent of uninsured Whites,” it found.

Before Rick Scott ran for governor, he was a leading Obamacare opponent. In 2009, the former hospital executive founded the group Conservatives for Patients’ Rights, an organization with $20 million behind it that’s designed specifically to oppose the Affordable Care Act. According to a Washington Postprofile of the organization, Scott used $5 million of his own money to fund the group.

When the Supreme Court held in 2012 that Medicaid expansion, along with several other provisions of the health-care law, are optional for states, Scott announced that he would not implement them. Though Scott has still refused to set up a state-run online insurance marketplace since Obama’s re-election, the governor has walked back some of his opposition. Last February, Scott even went so far as to say he would expand Medicaid. In a statement on his website, Gov. Scott said his office would “support a three-year expansion of our Medicaid program under the new healthcare law, as long as the federal government meets their commitment to pay 100 percent of the cost during this time.”

Over a year later, however, Florida has failed to take any more steps toward Medicaid expansion, and whether or not Gov. Scott will be able to garner support for the expansion from within his own party remains an open question. As the Tampa Bay Timesreported at the end of last year, Gov. Scott failed to press house Republicans to move forward with the plan. This year, the Florida legislature adjourned without accepting federal funds for expansion.

On Obamacare, Crist has gone from staunch opponent to fervent advocate. On the day President Obama signed the Affordable Care Act into law, Crist, who was then governor, tweeted: “Let’s keep up the fight and work to repeal this partisan, gov’t takeover of [healthcare].” He also tweeted, “Obama/Dems arrogantly trying to jam their gov’t run HC bill thru this week. Our country deserves a better, free market solution.” (A reporter at BuzzFeed took screen-shots of the tweets, which have since been deleted.)

But when Crist spoke to Ed Schultz on MSNBC in late 2013, Crist said he would help enact Obamacare, because it’s “the right thing to do.”

Sean Foreman told RH Reality Check that Crist’s public allegiance to the health-care law is a politically calculated position, but could hurt him in the end. “Charlie Crist defending Obamacare is a risky position,” Foreman wrote in an email. “The Crist campaign has calculated that this is a major issue for him in proving his bona fides for Democratic voters,” but most other Democratic candidates, particularly for congressional seats, are distancing themselves with the law to seem more moderate.

Whether Crist will be able to distinguish himself from his former party through the issues of reproductive rights and the Affordable Care Act remains to be seen.